Cross-sectional survey of underreported violence experienced by adolescents: a study from Indonesia

Background Global studies on adolescent victims of violence require serious attention due to the possibility that underreported cases may be higher than official records indicate. Since Indonesia expects to witness a demographic bonus, extensive research is needed to strengthen early detection, case handling, and prevention. Here, we report the outcomes of a survey on physical, verbal, and sexual violence experienced by adolescents in West Java, an Indonesian province inhabited by 18% of the country’s total population. Methods We conducted a cross-sectional survey in 2017 using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool for Children (ICAST-C) questionnaire for detecting child abuse; an expert panel translated, simplified, and validated it based on a theoretical framework that combines paediatrics, public health, and medicolegal perspectives. We aimed to cover a large sample size and explore three types of violence (physical, verbal, and sexual) that have high evidentiary value in the forensic context. The respondents were adolescents in the first and second grades of middle school (12 to 14 years old) and high school (15 to 17 years old) in seven cities/municipalities in the province, selected through several stages of simple random sampling (N = 3452). We analysed the samples through univariate (percentage), odds ratio (OR), comparison, correlation, and correspondence analyses. Results The results showed that 78.7% of the adolescents experienced violence in 2017, comprising those who encountered at least one incidence of physical violence (43.1%), verbal violence (12.2%), and sexual violence (4.5%). Data overlap includes 14.3% who experienced one type of violence in 2017, 7.4% who experienced two forms of violence, and 1.4% who underwent all three kinds of violence. The offenders were mainly adolescents across all types of violence, except for being forced to engage in sexual intercourse. Several victims of sexual violence did not state who the offenders were. Further, several characteristics showed a higher chance of experiencing violence than other characteristics, especially for adolescents who were still in middle school and those who lived only with their mothers. Correspondence analysis suggested subtle differences between characteristics. Conclusion We expect this study to help identify risk and protective factors that are essential to strengthening early detection efforts, decisive medicolegal examinations, case handling, and policy-making.

Mandated Child Abuse Reporting in a Multicultural Environment

The abuse and neglect of children has been linked to their cognitive, academic, psychological, and behavioral demise. As a result of the deleterious effects that abuse can have on children’s development and well-being, all 50 states, including the District of Columbia, have enacted child abuse reporting laws for mental health professionals. These laws typically require a mandated child abuse report when child maltreatment has been reasonably suspected. Although mandated child abuse reporting laws appear straight-forward, mandated reporting often entails complex and nuanced decision-making, particularly when a child is from a diverse cultural background. Thus, this article offers a discussion for mental health professionals (e.g., psychologists, psychiatrists, counselors, social workers) regarding mandated child abuse reporting within a multicultural environment.

Non-accidental Trauma in Infants: a Review of Evidence-Based Strategies for Diagnosis, Management, and Prevention

Purpose of Review To provide a resource for providers that may be involved in the diagnosis and management of infant non-accidental trauma (NAT). Recent Findings Infants are more likely to both suffer from physical abuse and die from their subsequent injuries. There are missed opportunities among providers for recognizing sentinel injuries. Minority children are overrepresented in the reporting of child maltreatment, and there is systemic bias in the evaluation and treatment of minority victims of child abuse. Summary Unfortunately, no single, primary preventative intervention has been conclusively shown to reduce the incidence of child maltreatment. Standardized algorithms for NAT screening have been shown to increase the bias-free utilization of NAT evaluations. Every healthcare provider that interacts with children has a responsibility to recognize warning signs of NAT, be able to initiate the evaluation for suspected NAT, and understand their role as a mandatory reporter.

Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life

The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.

MALTRATO INFANTIL Y TRASTORNOS CLÍNICOS POST-VIOLENCIA EN NIÑOS MENORES DE CINCO AÑOS

Introducción: El maltrato infantil (MI), se ha convertido en un problema de salud pública que impregna todos los sectores sociales y cuyo impacto resulta devastador no solamente durante su infancia, sino a lo largo de toda su vida. Objetivo: Describir el maltrato infantil y trastornos clínicos post-violencia en niños menores de cinco años. Métodos: A documentary research was carried out in databases such as SciElo, Pubmed, Google Scholar and, LATINDEX, using the descriptors: child abuse, child abuse, family relationships, family violence, published in the period 2010-2021, in languages English, Spanish and Portuguese. Resultados: Se considera que, el maltrato infligido en los primeros cinco años de la vida del menor, repercute en el desarrollo neurobiológico y psicológico, el cual tiende a ser más rápido que en los años siguientes de las etapas del desarrollo. El maltrato infantil, no solo consiste en la presencia de hematomas, quemaduras, traumas craneales, la negligencia y la desnutrición. Se asume el maltrato infantil como todo aquel daño emocional que acompaña a los actos abusivos o negligentes que se traducen como trastorno de estrés agudo y el trastorno de estrés postraumático, con su repercusión a largo plazo. Conclusiones: El maltrato infantil puede afectar el exitoso desarrollo del niño no sólo en un determinado período de desarrollo, sino a lo largo de toda su vida. Un equipo multidisciplinario, que ejecute estrategias de prevención, la necesidad inclusión de todos los países en esta lucha y entender que la prevención es la única salida Palabras claves: maltrato a los niños, abuso de los niños, relaciones familiares, violencia familiar ABSTRACT Introduction: Child abuse (MI) has become a public health problem that permeates all social sectors and whose impact is devastating not only during childhood, but throughout their entire lives. Objective: To describe child abuse and post-violence clinical disorders in children under five years of age. Methods: A documentary investigation was carried out. Through the search for scientific articles, in databases such as SciElo, Pubmed, Google Scholar and, LATINDEX, using the descriptors: child abuse, child abuse, family relationships, family violence. With inclusion criteria: full articles, in national and international journals and organizations such as WHO, PAHO, published in the period 2010-2021, in English, Spanish and Portuguese languages. Results: It is considered that the abuse inflicted in the first five years of the child's life affects the neurobiological and psychological development, which tends to be faster than in the following years of the development stages. Child abuse not only consists of bruises, burns, head trauma, neglect and malnutrition. Child abuse is assumed as all the emotional damage that accompanies abusive or negligent acts that translate as acute stress disorder and post-traumatic stress disorder, with its long-term repercussions. Conclusions: Child abuse can affect the successful development of the child not only in a certain period of development, but throughout their entire life. A multidisciplinary team, which executes prevention strategies, the need to include all countries in this fight, and understands that prevention is the only way out Keywords: child abuse, child abuse, family relationships, family violence